Assessment of statin therapy in non-diabetic patients attending a medical clinic in a tertiary care institution of Sri Lanka

Background: Dyslipidaemia is a major risk factor for Atherosclerotic Cardiovascular Disease (ASCVD) and cholesterol lowering treatment reduces cardiovascular risk. The 2013 American College of Cardiology (ACC) /American Heart Association (AHA) guidelines on dyslipidaemia, provide an important framework for the cardiovascular risk reduction strategy.

 

Objectives: To assess treatment gaps regarding statin therapy among patients without diabetes presenting to a medical clinic using standards set by the 2013 ACC/AHA guidelines.

 

Methodology: A descriptive cross-sectional study was conducted for 6 months from December 2016, at the outpatient medical clinic, Teaching Hospital Kandy. A sample of nondiabetic patients, between 40-75 years was included. Data such as patient demographics, ASCVDs, cardiac risk factors, blood pressure, lipid levels and statin history were gathered from patients and their clinic records. Statin requirement was assessed according to the guidelines.

 

Results: A total of 496 subjects were included. Mean age was 57.4 (SD 8.4) years and 66.5% were females. 270 (54.4%) patients were recognized to benefit from statin therapy, and the rest not to benefit from statin therapy. From 270 statin benefit patients, only 72 (26.6%) were on the recommended dose of statin therapy and 70 (25.9%) were not being treated with any statin. 144/226 (63.7%) patients who were non statin benefit were taking a statin.

 

Conclusions: A majority of patients who required statin therapy were not on a statin or on the recommended dose, whereas a large number of patients who did not require a statin were on a statin. It is recommended to initiate statin therapy in appropriate dose after assessing total ASCVD risk.